PMV
Conditions
Keywords
prolonged mechanical ventilation, weaning ventilator, abdominal weight training, cough machine
Brief summary
The patients with prolonged mechanical ventilation (PMV) have the risk of ineffective coughing and infection due to diaphragm weakness, making it more difficult to wean. This study aimed to explore the intervention of abdominal weight training (AWT) with/ without cough machine (CM) on lung function, respiratory muscle strength and cough ability in these patients.
Detailed description
Methods 40 patients with PMV were randomly assigned to three groups: AWT group (n=12), AWT+CM group (n=14) and control group (n=14). The effectiveness on pulmonary function, respiratory muscle strength and cough ability were compared among these three groups.
Interventions
Cough machine training is based on the cough assist machine Comfort Cough II (CC20), in which the inhalation and exhalation times are adjusted to 1-3 seconds, and the positive and negative pressure of the lower pressure 10-15 cmH2O is gradually increased to 30-40 cmH2O for the first time, 4-6 cycles/time, repeated 4-6 times, twice a day, five days a week, until the subject is weaned off the ventilator or transferred out of the ward. A modified Borg scale was used as an indicator of perceived dyspnea.
abdominal weight exercise training (sandbag) is maintained for 30 minutes; the starting weight is 1kg to 2kg, and the previous day's weight is maintained each day as well as adding 0.5kg daily.
Sponsors
Study design
Intervention model description
AWT group (n=12), AWT+CM group (n=14) control group (n=14).
Eligibility
Inclusion criteria
* (1) Invasive ventilator users, * (2) Hemodynamically stable, * (3) Intubated endotracheal tube or tracheotomy tube, * (4) Clearly conscious and cooperative, * (5) Vital capacity (VC) \<10ml/kg
Exclusion criteria
* (1) Unconscious or unwilling to sign the informed consent form, * (2) No spontaneous breathing, * (3) Active bleeding with unstable hemodynamics, * (4) Acute infection symptoms, * (5) Abdominal distension, digestion problems (including nausea and vomiting), * (6) Severe heart failure (ejection fraction ≤ 30%), * (7) Unhealed wounds in the chest and abdomen, * (8) Bullous emphysema, * (9) Sensitive pneumothorax or mediastinal pneumothorax, * (10) Recent history of traumatic stress, * (11) Acute head and neck injury (unless the injury site is immobilized)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum inspiratory pressure change by the intervention | Change between 1 day before and 2 weeks after the intervention | lung function |
| Maximum expiratory pressure change by the intervention | Change between 1 day before and 2 weeks after the intervention | lung function |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| vital capacity change by the intervention | Change between 1 day before and 2 weeks after the intervention | lung function |
Countries
Taiwan